Tuesday, November 27, 2007

MADRID, Spain (AP) -- Police arrested at least six people Monday in raids on clinics suspected of carrying out illegal abortions in Spain, officials said.

Four facilities in Barcelona were being searched, said a Civil Guard official in the city who could not be identified named under rules barring his name from being published. The official would not say what illegal activity the clinics were suspected of doing.

Spain allows abortions in cases of rape, fetal deformation or danger to a pregnant woman's physical or mental health. In the last instance, this danger must be certified by a doctor other than the one who would carry out the abortion.

The raids were ordered as part of an investigation that began following a complaint by an anti-abortion group called E-Cristians, the Civil Guard official said.

That complaint was filed in January after Danish television broadcast a documentary in which the gynecologist who runs the four raided clinics, Dr. Carlos Morin, was filmed offering to perform an abortion on a female journalist posing as being nearly seven months pregnant, said Pablo Molins, a lawyer for E-Cristians.

The doctor dispensed with the medical-certificate requirement and offered her a form in which she could state she suffered from a grave mental disorder, Molins said.

Thursday, November 15, 2007

By Carole Joffe, University of California November 8, 2007 - 8:12amArticle Link

"I actually went down on my knees begging him-but I think he felt he had been doing too many lately, and his hospital had been breathing down his neck. I walked out of there shaking...."

"I groveled and flattered him as much as I could. I sweet talked him. Finally he caved."

These are two stories of women physicians imploring male colleagues on behalf of patients who need abortions. The two events took place more than forty years apart, but the dynamics are eerily similar. The first speaker, Dr. Ethel Bloom (not her real name), now a retired general practitioner, is recounting for me her memories of what it meant to be an abortion-sympathetic doctor before Roe v Wade.

The daughter of her best friend, about to leave for college, had become pregnant. Dr. Bloom tried to obtain an abortion for her from an ob/gyn colleague who occasionally took risks and did abortions in his hospital, violating the rules of that time by claiming "medical necessity." (Bloom's gutsy, and ultimately successful, strategy for obtaining an authorized abortion in this case was to lie to another doctor that the young woman had tested positive for rubella, also known as German measles. The hospitals in the area had just begun to approve abortions for women with rubella, as evidence accumulated of the severe birth defects associated with the disease. As the first generation of tests were expensive, Bloom gambled -- correctly -- that the hospital would not retest her.

The second speaker, Dr. Margaret Riley (not her real name), is a vibrant and witty ob/gyn in her forties. In a just world, a woman like this would not have to "grovel," as she put it, before colleagues to get needed care for her patients. She currently is the medical director of a freestanding abortion clinic in an East Coast state and I recently heard her speak at a conference. A small portion of the patients who come to her clinic are too sick to have their abortions performed there safely and require having the procedure done in a hospital. This is when the groveling starts, as Riley has to deal with individuals and institutions beyond the clinic.

The case she discussed at the conference concerned a 17-year-old teenager with a history of recurrent pulmonary embolism (blood clots in the lungs). When the teen became pregnant, her hematologist suggested termination as the safest course, as pregnancy could dangerously exacerbate her condition, possibly leading to death. With the hematologist's backing, Dr. Riley arranged to perform the abortion in a local hospital. The young woman was admitted to the hospital, and prepared for surgery.

Literally as she prepared to leave for the hospital to do the procedure, Dr. Riley was informed by a clinic staff member that someone from the patient's insurance company had just called to announce that the company refused to authorize payment for the abortion. An in-hospital procedure would cost thousands of dollars, money which the family of the teenager did not have. Riley called the medical director of the company. "He said they would only pay if the ‘condition is life-threatening.' Of course, I wanted to shout, ‘You moron! Don't you know pregnancy in a patient with pulmonary embolism is life threatening?!' But I restrained myself. I calmly kept telling him how sick she was. I told him that the she had been on the pill but had to go off because of her condition....Finally, the breakthrough came when I got the hematologist to call him, and confirm how sick she was. Then he agreed. Of course, he thought that I, the abortion doctor, was doing this just for the money -- but a hematologist, well that was a a different story."

This case of the 17-year-old with pulmonary embolism was just one of several that Dr. Riley discussed which described the challenges she faces when advocating with gatekeepers for women too sick for clinic abortions. The negotiations that Riley has to undertake routinely with hospital administrators, insurance executives, and physicians in other specialities in such instances gives us yet another window into the chaotic and Kafkaesque world that is contemporary abortion provision, even as Roe remains technically legal. Some of those with whom Riley must plead are quite upfront with her on their anti-abortion views, others have different motivations. When I asked her, in a follow-up interview, whether she thought the insurance director was motivated primarily by anti-abortion sentiments or by a desire to cut costs, she gave an answer that seemed to encompass both: "I think it was sexism actually."

Margaret Riley's situation, in fact, is in some respects better than that of her fellow clinic directors in other areas. She operates in a fairly liberal state, and over the years, has worked out an "understanding" with a local hospital that usually lets her perform abortions for very ill patients in its facilities. But in other places, hospitals' refusals to deal with seriously ill women seeking abortions is so egregious that a new term has entered the vocabulary of abortion advocates -- "ambulance cases." Mainly, but hardly exclusively, occurring in Catholic hospitals or hospitals which have merged with Catholic institutions, the phrase refers to situations in which very ill women are sent from one hospital to another in an ambulance because the first hospital refuses to treat them. Here the pleading done by abortion providing ob/gyns with members of hospital ethics committees or heads of departments often falls on deaf ears.

Two particularly notorious cases occurred a few years ago in a Chicago suburbs, in a community hospital that merged with a Catholic institution. In the first case, a woman with an ectopic pregnancy -- a potentially life threatening situation -- was discharged from the hospital and sent by ambulance to another hospital. Because a fetal heartbeat was detected, the first hospital refused to perform an abortion (though they did offer to remove her fallopian tube, which would have compromised future fertility).

In the second case, a patient's water membrane burst prematurely at 18 weeks, putting her at risk of chorioamnionitis, an infection of the uterus that can cause high fever and is associated with sterility. Though the typical course in such situations is to induce labor before the infection develops, the hospital refused to do so until the patient developed a fever. The frustrated admitting physician sent the patient to another hospital for immediate treatment.

As Leo Tolstoy famously said at the beginning of Anna Karenina -- "all unhappy families are unhappy in their own way" -- we can say of the contemporary abortion scene, that all sites of provision are deeply challenged in their own way. The clinics, of course, have no shortage of problems, facing onerous restrictions and constant harassment. But hospital-based abortion care, especially when very ill patients are involved, pits the abortion provider against a host of more powerful forces, some truly astonishing in their disregard for women's health and wellbeing. And proud physicians like Margaret Riley are resigned to the fact that they will be doing a a lot of begging.

Rebecca Gomperts, abortion doctor and activist, arrives straight from Heathrow, dressed in a smart suit, a big smile lighting up her girlish face. She is stopping off briefly en route to another engagement - a special screening of the film Vera Drake. She isn't keen. "I've seen it lots of times," she sighs, adding mischievously: "I'm going to try to get out of it."

The event has been organised to tie in with the 40th anniversary of the 1967 abortion act, which is also the reason Gomperts, 41, is in Britain. She is the founder of Women on Waves (WoW), a radical Dutch organisation that sails an "abortion ship" to countries where the procedure is illegal, before taking women out to the safety of international waters to provide terminations.

Gomperts' reluctance to see the Mike Leigh film is not because she is uninterested in the subject matter then. Her passion is evident, but after eight years of being involved in the fray over the abortion debate, she is keen to focus solely on her next voyage. Her goal, she states firmly, is to "get out of Europe".

"So far we have sailed to Ireland, Poland and Portugal, all when abortion was illegal, with varying degrees of success, but we are looking to visit either South America or Africa next summer," she says. "Wherever we go there is a lot of press attention and opposition from anti-abortion groups but it is in developing countries that women really suffer because of unsafe and illegal abortions. That is why it is important for us to go there and raise awareness, however difficult it may be."

An article published in the Lancet medical journal earlier this year backs up her view that the burden of unsafe abortion is borne disproportionately by the poor, the disadvantaged and the young. There are an estimated 210m pregnancies worldwide each year, of which one in five ends in an abortion. An estimated 20m unsafe abortions are carried out each year, 97% of them in developing countries. According to the International Planned Parenthood Federation (IPPF), complications from unsafe abortions account for 70,000 deaths annually, as well as countless injuries.

"It's such a waste of life," says Gomperts. "As a doctor, I look at the abortion issue from a health perspective and the fact is that an early abortion is safer than giving birth. That is not meant to promote abortion because if women want to have children it is a risk they are naturally willing to take. However, if they don't want them they should never be forced to take that risk."

It was a stint as resident doctor aboard Greenpeace's Rainbow Warrior II boat that inspired Gomperts to set up WoW. She was shocked by the number of women who were either suffering from botched back street abortions, or struggling to cope with several mouths to feed, in countries where the procedure is illegal or severely restricted. She became determined to find a way to help them. "I remember meeting an 18-year-old girl in South America who was desperately trying to take care of her three younger brothers and sisters. She had recently lost her mother because of a backstreet abortion. Her mother had been pregnant for a fifth time and couldn't support another child so she had gone down the illegal route. I thought, how is it possible that a whole family has lost their mother just because she couldn't get a safe and legal abortion?

"I went back to the Rainbow Warrior and told the crew the story and how I wanted to help and they said that if you had a Dutch-registered ship it would be subject to Dutch law and so it would be legal to provide abortions in international waters. It seemed like the perfect solution. Of course, I had no idea at the time what I was taking on."

Gomperts' plan was to raise enough money to buy her own ship, which would be properly equipped with the necessary medical equipment and treatment rooms, but it quickly became clear that this wouldn't be possible. Pro-choice groups don't attract the level of donor support often enjoyed by pro-life organisations, so Gomperts turned to Plan B: finding funds for a mobile clinic that could be transferred to a hired ship for each voyage.

By 2001 everything was in place for WoW's first trip. For practical reasons as much as need - proximity to the Netherlands and the lack of a language barrier - the destination was Dublin harbour. So with a cargo consisting of condoms, IUDs, the "morning after" pill and the abortion pill RU-486, a crew of six women and two men set sail.

"I was very naive when we went to Ireland," Gomperts says. "I think you have to have a certain amount of naivety to do something like that because if you knew what was ahead of you, you probably wouldn't do it. I had made good links with local abortion rights groups and they were very keen for us to come and raise awareness but initially they didn't want us to offer abortions. I always said that if we couldn't do abortions the whole trip was pointless, so we left it that we would offer medical abortions with the abortion pill." (Medical abortions involve taking pills that induce an early miscarriage, while surgical abortion - which the ship doesn't offer - is performed under local or general anaesthetic.)

However, it became clear when Gomperts arrived in Ireland in the full glare of the world's media that she had underestimated how controversial the trip would be. While the ship was en route, conservative members of the Dutch parliament had announced that WoW was not licensed to offer the pill legally. It was made clear to Gomperts that she could face imprisonment if she continued with her project. "It was a complete nightmare. We had such high hopes when we set off from the Netherlands, only for them to come crashing down when we hit port. The legal issues were cleared up a year later but there were so many obstacles that it was impossible to solve them in a few days."

It was a major setback and press coverage was mainly negative. Headlines included "Dutch activists renege on abortions promise" and "Abortion boat admits Dublin voyage was a publicity sham". In the end, the ship distributed all its contraceptives and "morning after" pills and received more than 200 calls from women requesting abortions they couldn't provide.

"I was surprised by how much impact the trip had politically," Gomperts says. "I think abortion is one of those issues within the EU where countries don't want to interfere with each other's policies. This was a very visual challenge to Ireland's policy and, being a Dutch ship, it made some people nervous. There are other organisations in the Netherlands that work for abortion rights but they just use advocacy and not loopholes in the law. We use these loopholes but I don't see it as any different from women travelling to England to have abortions, which happens all the time. The difference is, the ship is a symbol of freedom of choice."

Indeed Gomperts' methods are deliberately confrontational. She uses direct action, which is more associated with the anti-abortion movement, and seems unconcerned at being such a figurehead for her cause. Given the lengths that some groups will go to prevent abortions, isn't she ever afraid?

"No," she says. "I have never worried about my safety - other people do, but I don't. People are very passionate about this issue and I recognise and respect that. The most aggressive crowd I have seen was in Poland when we visited in 2003. We had to have a lot of security because the anti-abortion protesters were throwing eggs and red paint and it got quite unpleasant. However, when you are in the middle of a campaign there is so much to think about that fear is not an emotion you feel. You just have to get on with it."

There have been some successes. In 2004 when Women on Waves sailed to Portugal they were blockaded by two war ships, which refused to let them enter Portuguese waters. Gomperts says this "disproportionate response" by the government caused such a furore in the country that it ensured abortion was a key issue in the 2005 election, which ended with the ruling party being replaced by the Socialist party. In February this year, Portugal held a national referendum on abortion and in April, President Cavaco Silva ratified a law allowing women to obtain abortions until the 10th week of pregnancy.

It is this kind of success that propels Gomperts forward, she says. She has recently been battling with the Dutch government for permission to provide abortions on the ship until the 12th week of pregnancy, instead of the seven weeks that the organisation's licence currently covers.

"There is a very small window in which we can help women at the moment. I would like that extended because it is still safe under the conditions we provide.

"We would never provide surgical abortions purely for practical reasons. You need at least 20 minutes for each woman so we would have to stay out in international waters for a lot longer. We also know that the services we provide will never be able to meet the demand. It is a symbolic gesture. We know we won't solve the problem."

Gomperts was born in Suriname (her father is from the former Dutch colony) before moving at the age of three to the Netherlands, her mother's country. Most of her formative years were spent in the port of Vlissingen before she moved to Amsterdam to study art and medicine. She wanted to be an artist but says she wasn't "good enough". After various medical internships, she stumbled across abortion as a specialty.

"It is a profession where you can really help somebody in a very complete way. You need a lot of psychological and surgical expertise, so even though it is a very small field there is a lot of variety. It is also one of those issues that the more you know, the more the injustice gets to you. Now my aim is to take this whole debate outside the high ground of morality because it doesn't have anything to do with morality. Many women who I have helped have said they are generally against abortion but that their situation is 'different'.

"Even if you are against abortion you might face a moment where your situation is 'different'. My work is about ensuring there is a fundamental respect that a woman can make that decision for herself at that point in her life."

During her time as director of WoW, Gomperts has had two children; one is two, the other 14 months. Has motherhood changed her perspective? "Of course having children has changed me as person, but it hasn't changed the way I feel about abortion. If anything, it has become even clearer to me how important it is that [having children] is something you really want. I enjoy it tremendously but it is so demanding that it must be a voluntary decision."

Gomperts has been called many names since setting up her organisation, one of which - "pirate" - elicits raised eyebrows and a resigned shake of the head when I mention it. But how would she describe herself?

"That's too difficult," she replies. "I guess one of my strengths has been to make the impossible possible. When people say you can't do it I become determined to make it happen. If I don't, who else will?"

Tuesday, November 13, 2007

Thousands of women in Ghana are seeking dangerous, illegal abortions every year with many ending in death or disability.

In Ghana abortion is widespread and, because it is technically illegal, mainly unregulated.

It is estimated that as many as two-thirds of all terminations are unsafe and large numbers of women are dying.

Gloria is 22 and lives in a village in eastern Ghana.

She has had two abortions in two years and has not told her family as she is afraid she will be thrown out.

Her village is governed by traditional tribal customs.

Both abortion and contraception are frowned upon and children are seen as precious.

But Gloria does not want children yet - she wants to continue her schooling.

So, with the help of a friend she resorted to self-abortion. But it all went badly wrong.

"The first method I used were the leaves of the bush plant mixed with kawa, a local stone," she told BBC Radio 4's Crossing Continents.

"We ground them together and inserted it into the uterus."

But that method did not work and in a small, quavering voice, Gloria said: "Then we inserted the branch of the bush plant and the blood started coming in 15 minutes."

Broken bottle

Gloria's second abortion was only four months ago.

First her friend gave her melted sugar with Guinness. No effect.

Then 10 paracetemol tablets ground up with local gin. Still nothing. "Finally, we tried a broken bottle ground up with seawater and "Blue", a washing detergent, which we soaked in a cotton cloth and inserted into my womanhood," she confessed.

"By doing that the foetus came. I bled and bled and bled for more than five days."

Gloria is today in constant pain and too afraid to see a doctor.

She has refused to tell even her mother, who is a midwife.

"If I informed my mother, she would tell my father and that would be the end of me," she explained.

Infertility fear

Other women in both rural Ghana and the cities echo these fears.

In the capital Accra, Gracie, Betty and Debbie spoke about their abortions.

They are all young, single mothers, abandoned by their men and struggling as low-paid market traders.

Betty is just 26.

"Nobody knows, not even my friends. I thought I'd get in big trouble," she said.

The abortion cost 300,000 cedis (about £16), which she said was a lot of money for someone like her. She continued: "Since my abortion I've not been able to get pregnant again. That was five years ago.

"But I am fortunate because a friend of mine died after hers."

Money was also a big issue for Debbie.

Her boyfriend got her pregnant and then left her.

But her brother gave her money after she lied, saying she needed it because she had malaria.

At the hospital the doctor told her an abortion would cost 500,000 cedis (about £28) but she had only 400,000.

However she pleaded with him and the operation went ahead.

"But that night," Debbie related, "I had terrible pains. I went back to the hospital. The doctor had left part of the foetus in my womb."

Serious infection

And finally, Gracie's story.

Her abortion also took place in a hospital and was also botched. The doctor who operated on her was not a gynaecologist.

He used dirty instruments and she got a serious infection.

She nearly lost her right leg.

"When I sit down my leg shakes. I can't sleep," she said.

In Africa, Ghana's abortion law is considered relatively liberal.

Technically it is illegal but there are three broad and flexible exceptions which mean women can demand legal terminations.

They are: if she gets pregnant as a result of rape, incest or reduced mental ability; if the pregnancy poses a risk to her physical or mental health, and if the unborn child might suffer an abnormality or disease.

But that is if they know the law at all and that is a major problem.

Women and girls, doctors, quacks, the police, even judges, have all been shown to be ignorant of Ghana's law, or have wilfully broken it knowing they will not be caught.

Lucrative trade

Gynaecologist Dr Joe Taylor - an advisor on reproductive health to the government - often treats women after botched abortions. "I've seen many, many, women dying and what is most tragic is that those who don't die suffer disabilities that are life-long and painful," he said.

"Abortion is carried out in this clandestine and dangerous way because most people perceive it to be criminal and illegal."

Ignorance and greed are the main reasons illegal abortion thrives, he said.

No-one knows the exact figures. Statistics are rare in Ghana.

The quacks and the charlatans can charge high fees, even from poor women.

"I often say the female pelvis is a goldmine. And if you're a miner you can make big money," Dr Taylor concluded.

The criminalisation of abortion along with traditional values, social perceptions and religious teachings have created a crisis in Ghana.

And across most of Africa, where it has been estimated that four million females a year undergo unsafe abortions, 30,000 of them die as a result.

One expert has called abortion "a killing field".

And there is little evidence to suggest that the situation will change soon.

Women die after Nicaragua's ban on abortions Law won't allow the procedure even when mother's life is at stakeThe Associated Pressupdated 6:53 p.m. ET, Tues., Nov. 6, 2007

MANAGUA, Nicaragua - Two weeks after Olga Reyes danced at her wedding, her bloated and disfigured body was laid to rest in an open coffin — the victim, her husband and some experts say, of Nicaragua’s new no-exceptions ban on abortion.

Reyes, a 22-year-old law student, suffered an ectopic pregnancy. The fetus develops outside the uterus, cannot survive and causes bleeding that endangers the mother. But doctors seemed afraid to treat her because of the anti-abortion law, said husband Agustin Perez. By the time they took action, it was too late.

Nicaragua last year became one of 35 countries that ban all abortions, even to save the life of the mother, according to the Center for Reproductive Rights in New York. The ban has been strictly followed, leaving the country torn between a strong tradition of women’s rights and a growing religious conservatism. Abortion rights groups have stormed Congress in recent weeks demanding change, but President Daniel Ortega, a former leftist revolutionary and a Roman Catholic, has refused to oppose the church-supported ban.

Evangelical groups and the church say abortion is never needed now because medical advances solve the complications that might otherwise put a pregnant mother’s life at risk.

But at least three women have died because of the ban, and another 12 reported cases will be examined, said gynecologist and university researcher Eliette Valladares, who is working with the Pan American Health Organization to analyze deaths of pregnant women recorded by Nicaragua’s Health Ministry.

Before the ban took effect on Nov. 18, 2006, fewer than a dozen legal abortions were recorded per year in Nicaragua. They were performed only when three doctors agreed a woman’s life was in danger. However, the Roman Catholic Church estimates that doctors and other medical staff carried out about 36,000 “secret” abortions a year, because under the old law they had little fear of government reprisals.

Hemorrhaging most common cause of deathThis year the Health Ministry has recorded 84 deaths of pregnant women between January and October, compared with 89 for all of last year and 88 the year before. It listed hemorrhaging as the most common cause, with 27 cases reported. The ministry refused to comment further on the ban.

Abortion rights groups have disrupted Congress several times, demanding that lawmakers lift the ban. On Oct. 25, unable to get past increased security, they held up signs at Congress’ front door that read: “Women assassins” and “They want to keep us quiet and dead.” A minority of lawmakers are still trying to lift the ban, but don’t have enough votes.

The Roman Catholic Church mobilized nearly 300,000 people to march and sign petitions in support of the ban.

“A child is not a sickness,” said Henry Romero, a priest who helped lead the campaign. “When two lives are in danger, you must try to save both the woman and the child. It’s difficult to say now that it isn’t possible to save both.”

Law student Reyes was one of the three confirmed fatalities. She knew something was horribly wrong, and went with her husband to their small town’s medical center. They were sent to Bertha Calderon maternity hospital, more than an hour away in Managua. There, Perez said, Reyes was given a cursory exam, sent home and told to return the next day.

By that time, the bleeding and cramping were worse. Perez said he rushed her to a hospital in nearby Leon, but after she had an ultrasound that confirmed her condition, they left her bent over and in agony for hours in a waiting room. When a doctor at a shift change saw her condition, she was rushed into surgery. She suffered three heart attacks and an exploratory surgery.

Valladares said doctors should have acted quicker.

“They knew she had a limited amount of time before she bled out. The whole world knows that with an ectopic pregnancy,” Valladares said. “They didn’t treat her, out of fear.”

The hospital director, Olga Maria de Chavez, said Reyes arrived late at night, and was told to return the next morning when specialists were available. The doctors who handled her case in Leon refused to talk to The Associated Press.

Walter Mendiata, president of Nicaragua’s Association of Gynecologists and a supporter of the abortion ban, said doctors are taking the new law too far. He argues that surgery for an ectopic pregnancy isn’t the same as carrying out an abortion.

“There’s no discussion in a case like that,” he said. “It’s urgent, and you operate.”

But he acknowledged that many doctors fear they will be accused of performing an abortion, which could mean a license suspension and several years in prison, even though no one has yet been prosecuted.

Some doctors privately admit to carrying out what they believe are illegal procedures, while others say they won’t jeopardize their careers.

“Many are thinking that instead of taking the risk, it is better to let a woman die,” said Dr. Leonel Arguello, president of the Nicaraguan Society of General Medicine.

Infections from illegal abortionsDoctors frequently see women coming in with infections, many likely brought on by illegal abortions that they refuse to disclose for fear they might be punished, said Dr. Carla Cerrato. Because the people with some medical training who used to do illegal abortions have disappeared, Cerrato said, women more frequently take drugs or pull the fetus out on their own using wires or other crude objects.

“What we are seeing are complications that before we never saw,” Cerrato said, sitting in the dingy pre-labor room at a crowded public hospital in Managua.

She added that she sees hysterectomies and severe infections that leave women sterile or dead because obstetricians can’t take any action that might harm a living fetus.

“We have to wait until the fetus dies,” she said. “But often, for the woman, it’s too late.”

That appears to be what happened with Reyes. Her aunt, Gioconda Reyes, a devoted Catholic dressed in a worn T-shirt in which Jesus promises eternal life, said the sudden death has changed her views.

“I don’t support abortion to get rid of unwanted pregnancies, but in cases like that of Olga’s, it is necessary,” she said, adding: “How could they let four days pass when every minute was precious? They denied her the right to medical care, to a life.”

Monday, November 12, 2007

(WOMENSENEWS)--Women in a majority of U.S. states risk losing the right to obtain an abortion due to changes on the Supreme Court bench and the proliferation of abortion bans--some enacted, some in waiting--the Center for Reproductive Rights said yesterday in its "What If Roe Fell?" report.

A reversal of Roe v. Wade--the 1973 Supreme Court decision that decriminalized abortion--would mean that abortion law falls to the states, where anti-choice activists are pursuing a steady, two-front attack against abortion rights.

On one front, activists are pushing contentious legislation challenging Roe that is designed to be fought up to the Supreme Court. In the last three years, 27 such abortion bans have been introduced in 14 states, including Colorado, Georgia, Missouri and West Virginia.

Other states--such as Alabama, Delaware, Massachusetts and Michigan--enacted bans prior to the Roe decision that are still on the books. Many of the pre-Roe bans have been overturned or at least not been enforced since 1973 but could be revived. Many include exceptions to protect the life or health of the woman.

On the second front, activists are introducing "abortion bans-in-waiting," or laws that would be enacted by a Roe reversal. Because these state-level bans are not yet law, it is not possible for pro-choice groups to mount legal challenges against them.

'Hard to Galvanize Public Response'

"It's a good strategy . . . a way for them to silently lay a foundation largely without public knowledge," says Katherine Grainger, state program director for the New York-based Center for Reproductive Rights. "Because they don't immediately go into effect now, it's hard to galvanize a public response."

There were no abortion-bans-in-waiting laws in 2004, the center's report notes, but by 2007 four states--Louisiana, Mississippi, North Dakota and South Dakota--had passed them. Another five states--Kentucky, Missouri, Oklahoma, Texas and Utah--have already considered or are currently considering them.

Authors of the report--including Grainger and other legal researchers--estimate as many as 30 states--including Ohio, Michigan, Louisiana, Indiana, Oklahoma and Texas--could pass legislation to restrict or altogether ban abortions in the wake of a Roe reversal.

Alaska, California, Florida, Maine, Vermont and New York are among the 20 where abortion is not expected to face immediate legal challenge.Changes on the Bench

As state activism pressures Roe from below, Roe is also vulnerable from above. Authors say changes on the Supreme Court--in particular the July 2005 retirement of Justice Sandra Day O'Connor, her replacement by Justice Samuel Alito and the appointment of Chief Justice John Roberts--have shifted the balance.

The Supreme Court's 5-4 decision last April in Gonzales v. Carhart upheld a federal law that banned a specific abortion procedure used after 12 weeks of pregnancy and eliminated the precedent that legal restrictions placed on abortion must include an exception to protect the health of the woman.

"I remember when abortion was illegal, the days of coat-hanger abortions," Sen. Dianne Feinstein, D-Calif., said at the report's launch. "I'm very worried a Supreme Court decision now would take us back there. It is time to mobilize women to fight."

Sixty-three percent of 1,000 registered voters surveyed agreed that Roe v. Wade is vulnerable, and 42 percent said they opposed leaving the matter up to the states rather than the Supreme Court, in a poll conducted by Lake Research Partners that accompanies the report. Seven in 10 respondents said the government should not interfere with abortions that are medically necessary.

The Center for Reproductive Rights, which promotes reproductive rights nationally and internationally, issued a similar report in 2004.Flagging a Quiet Effort

President Nancy Northup said the group updated the report to flag a quiet but "dramatic and frightening attempt to create a post-Roe world."

Legislative opposition to abortion rights is underway in 17 states and the report's authors say the goal is to get a case to the Supreme Court where a reversal of Roe v. Wade is now possible.

The year following O'Connor's departure a dozen states passed or attempted to pass laws to limit abortion rights. By 2007, the number of such bills that were introduced skyrocketed to 38 in 17 states. It was the most concerted legislative challenge since the early 1990s, when a 1992 Supreme Court decision--in Planned Parenthood v. Casey--held that a state could enact laws to affect access to abortion in the first trimester as long as exceptions to protect the health of the woman were secure.

The only states where abortion rights would be preserved are those that have protections established in their state constitutions, or where state laws are already in place, the report finds. "Given the variations in law and political climates in the 50 states, the overturning of Roe would result in a patchwork of rights in which women seeking abortions would be strongly protected in some states and completely denied the right in others, with different levels of protection in between."

Low-income women in particular would be affected, the report finds, because they already struggle to find and pay for a local, legal abortion.

"If Roe is overturned, there is a strong possibility that a clandestine, illegal underground will again emerge to meet the need for abortions, a need that virtually no one believes will disappear," the report warns, noting that seven of the 10 poorest states in the country are considered likely to ban abortions within a year of reversing Roe.

Pro-choice activists call for counter-activism to repeal existing legislation, preparation to battle new state restrictions and support for the Freedom of Choice Act, now being lobbied in Congress and some states.

Introduced last April by Rep. Jerrold Nadler, D-N.Y., and Sen. Barbara Boxer, D-Calif., the bill provides protection for women to make decisions regarding their individual reproductive health needs without any government interference, even if Roe v. Wade is reversed.

***

Juliette Terzieff is a freelance journalist currently based in Tampa, Fla., who has worked for the San Francisco Chronicle, Newsweek, CNN International and the London Sunday Times during time spent in the Balkans, the Middle East and South Asia.

Wednesday, November 7, 2007

Dr. Susan Wicklund took her first step toward the front line of the abortion wars when she was in her early 20s, a high school graduate with a few community college credits, working dead-end jobs.

She became pregnant. She had an abortion. It was legal, but it was ghastly.

Her counseling, she recalls, was limited to instructions to pay in advance, in cash, and to go to the emergency room if she had a problem. During the procedure itself, her every question drew the same response: “Shut up!”

Determined that other women should have better reproductive care, she began work as an apprentice midwife and eventually finished college, earned a medical degree and started a practice in which she spends about 90 percent of her time on abortion services. Much of her work is in underserved regions on the Western plains, at clinics that she visits by plane.

In her forthcoming book “This Common Secret: My Journey as an Abortion Doctor” (Public Affairs), Dr. Wicklund describes her work, the circumstances that lead her patients to choose abortion, and the barriers — lack of money, lack of providers, violence in the home or protesters at clinics — that stand in their way.

But she said her main goal with the book was to encourage more open discussion of abortion and its prevalence.

“We don’t talk about it,” she said in a telephone interview. “People say, ‘Nobody I know has ever had an abortion,’ and that is just not true. Their sisters, their mothers have had abortions.”

Dr. Wicklund, 53, said that at current rates almost 40 percent of American women have an abortion during their child-bearing years, a figure supported by the Guttmacher Institute, which researches reproductive health policy. Abortion is one of the most common operations in the United States, she said, more common than tonsillectomy or removal of wisdom teeth. “Because it is such a secret,” she said, “we lose sight of how common it is.”

But Dr. Wicklund acknowledges that abortion is an issue fraught with dilemmas. In the book, she describes witnessing, as a medical student, the abortion of a 21-week fetus. She writes that at the sight of its tiny arm she decided she would perform abortions only in the first trimester of pregnancy. She says late-term abortions should be legal, but her decision means she occasionally sees desperate women she must refuse to help.

Dr. Wicklund describes her horror when she aborted the pregnancy of a woman who had been raped, only to discover, by examining the removed tissue, that the pregnancy was further along than she or the woman had thought — and that she had destroyed an embryo the woman and her husband had conceived together. And she describes the way she watches and listens as the women she treats tell why they want to end their pregnancies. If she detects uncertainty or thinks they may be responding to the wishes of anyone other than themselves, she says, she tells them to think it over a bit longer.

On the other hand, Dr. Wicklund has little use for requirements like 24-hour waiting periods, or for assertions like those of Justice Anthony M. Kennedy, who said in a recent Supreme Court decision on abortion that the government had an interest in protecting women from their own decisions in the matter.

“It’s so incredibly insulting,” Dr. Wicklund said in the interview. “The 24-hour waiting period implies that women don’t think about it on their own and have to have the government forcing it on them. To me a lot of the abortion restrictions are about control of women, about power, and it’s insulting.”

Dr. Wicklund said she would put more credence in opponents of abortion rights if they did more to help women prevent unwanted pregnancies. Instead, she said, many of the protesters she encounters “are against birth control, period.” That is unfortunate, she said, because her clinic experience confirms studies showing that emphasizing abstinence rather than contraception may cause girls to delay their first sexual experience for a few months, but “when they do have intercourse they are much less likely to protect themselves with birth control or a condom.”

According to the Guttmacher Institute, about a quarter of pregnancies in the United States end in abortion. Dr. Wicklund says that is why she believes far more people favor abortion rights than are willing to admit it in polls. For example, she said in the interview, an abortion ban that seemed to have wide support in South Dakota was put to a vote and “when people got behind those curtains and nobody was watching it was overwhelmingly defeated. Unfortunately, people are not willing to say what they really think.”

One of these people might be a woman she recognized as one of the protesters who regularly appeared, shouting, outside a clinic where she worked. Only now the woman was in the waiting room, desperate to end an unwanted pregnancy. Dr. Wicklund performed the procedure.

And then there is Dr. Wicklund’s maternal grandmother, a woman she was afraid would disapprove of her work. But it turned out that she had a story of her own. “When I was 16 years old, my best friend got pregnant,” is how the story began. Her friend turned to her and her sister for help. They did the only thing they could think of — putting “something long and sharp ‘up there,’ ” according to the book. The girl bled to death, and the cause of her death was kept secret.

“I know exactly what kind of work you do,” the grandmother told Dr. Wicklund, “and it is a good thing.” One question Dr. Wicklund hears “all the time,” she said, is how she can focus on abortion rather than on something more rewarding, like delivering babies.

“In fact, the women are so grateful,” Dr. Wicklund said in the interview. “Women are so grateful to know they can get through this safely, that they can still get pregnant again.

“It is one of the few areas of medicine where you are not working with a sick person, you are doing something for them that gives them back their life, their control,” she added. “It’s a very rewarding thing to be part of that.”

Sunday, November 4, 2007

November is National Adoption Awareness Month: time to take stock and rethink our adoption practices and goals.

Recent headlines reveal such contradictions as:

- 3,700 U.S. families in the process of adopting children from Guatemala are concerned, upset and unsure about their pending adoption because of Guatemala’s crack down on child trafficking.

- British Foreign Secretary David Miliband and his wife are joyously celebrating their second adoption: both adopted as newborns fresh from American delivery rooms.

- Six French “child rescuers” are among sixteen jailed for illegally taking 103 children from Chad who were neither starving nor orphaned.

Adoption Awareness Month was intended to increase the awareness of the needs of US orphans in foster care who could benefit from adoption. Today, such children number in excess of 100,00 of the half million children in foster care, while we promote and encourage adoption without distinguishing these children from infants who are sought after.

The U.S. imports more infants for adoption that any other nation, while also exporting Black children to Canada and white infants to the wealthy in Britain, Mexico and elsewhere in a seeming endless redistribution redistributing these marketable commodities as private entrepreneurs profit from their demand with little to no regulations.

L. Ann Babb, author of Ethics in American Adoption. reports that American adoption “[professionals] have yet to develop uniform ethical standards… or to make meaningful attempts to monitor their own profession … In other professions and occupations, licensing or certification in a specialty must be earned before an individual can offer expert services in an area. The certified manicurist may not give facials; the certified hair stylist may not offer manicures ….Yet…individuals with professions as different as social work and law, marriage and family therapy, and medicine may call themselves ‘adoption professionals’.”

Babb continues: “There remains no national professional organization for adoption specialists, no professional recognition of adoption practice as a specialty of any discipline, no established education and training requirements, and no regular professional meetings and forums for adoption ‘professionals'.”

Brits are lauding America’s lax regulations that allowed the Miliband’s to twice adopt an American infant. The British media articles bemoan the fact that Britain does not allow such exploitive measures, as if adoption was about providing babies in the quickest way possible with the least amount of red tape, eliciting comments such as:

American websites currently offer[ ] mouth-wateringincentives to would-be buyers. "Delivery within fourmonths", "Discounts of up to $19,000", they proclaim.If it were cars they were selling this would not seemodd, but it's babies that are for sale – bright,smiling newborns to tempt the childless into partingwith about £20,000.There is no shame in treating babies like any otherpurchase in America, where the adoption industry islargely privatized… (“Why adoption is so easy inAmerica” Telegraph.co.uk 10/31/07)

Is there no shame?

Why are infants such as these are leaving the US while US couples are traveling half way around the word to meet their desire for a baby when both countries have children in foster care?

The answer is that adoption is far from an altruist social program to care for needy orphans. Instead, adoption is a business; babies are priced based on age, race, ethnicity, health, and physical ability. It all sounds vulgar because it is.

“It feels harsh to use concepts like supply and demand when talking about children and obviously it’s wrong to say that international adoption is just a trade in children,” says Riitta Högbacka, University of Helsinki, Finland, reporting on the global market for adoption . “But if we look at the direction of this human flow—which countries are sending children, which countries are receiving and who is doing the adopting—then it is very clear. It goes from the South to the North and from the East to the West. The recipients are always the richer countries in North America, Europe, and Australia.

Evan B. Donaldson Institute for Adoption, Anaheim Conference “Money, Power and Accountability: The ‘Business’ of Adoption” summary: No., 1999, concludes:“Thinking of adoption in economic terms is an uncomfortable reality. There has been a deterioration of the constraints once put in place to protect members of the triad from exploitation, with market factors such as inflated inventories, scarce commodities, demographic trends in the marketplace, products in oversupply, and the principles of supply and demand affecting adoption services.”

“Profit-based motivation in child placement [that] is … loathsome” and “largely driven by money… Money has become the critical variable for determining who gets a child….” according to L. Anne Babb: The fees western adopters are willing to pay to obtain a child often support a lucrative black market coercing mothers, stealing and kidnapping babies and children that are sold to orphanages to be internationally adopted.

International adoption has become an unregulated “entrepreneurial venture,” according to Debra Harder, network director for Adoptive Families of America. (Laura Mansnerus, “Market Puts Price Tags on the Priceless” New York Times, October 26, 1998)

Högbacka additionally finds that internationally, as well as domestically: “Demand is focused on quite a small group of under three-year-olds, where the number of potential parents far exceeds the supply of children.” (Feb 22, 2006 “The global market for adoption.” SixDegrees cover story)

Child trafficking for adoption is an issue of concern addressed by UNICEF and other non-profit watchdog agencies throughout the world. Sandra Soria, executive director of Peru’s nonprofit Institute for Infancy and the Family said: “It’s a situation that favors the proliferation of these trafficking rings and creates the markets and conditions for these international networks to operate,” said. Soria notes that it is impossible to know how many children are sold each year, for adoption, forced labor, or the sex trade. (Rick Vecchio, “Pregnant Teen’s Murder Shocks Peru.” Associated Press, March 13, 2006.)

The recent incident in Chad illustrated the fact that worldwide 80% of children targeted for international adoption have parents. Even those in orphanages have family who visit them and use these institutions for temporary care. Such was the case with the family of David Banda who Madonna adopted. Children who are truly orphaned, could be adopted within their own nation if not for the competition of foreign fees to orphanages.

Program director of International Social Service, Chantal Saclier is responsible for the United Kingdom’s ISS Resource Centre on the Protection of Children in Adoption. Saclier finds that although inter-country adoption is intended to find stable homes for children who do not have the opportunity for a loving family environment, many of the children being adopted have a family that could have been preserved. Factors such as pressure from wealthy adoptive families, and the selfishness and greed of officials, have created a situation in which economically disadvantaged children are exploited and sold. (Chantal Scalier, “In the Best Interests of the Child? International Resource Centre for the Protection of Children in Adoption.” In: Selman, P., Ed.)

Peter Dodds, author Outer Search\Inner Journey: An Orphan and Adoptee's Quest finds: “International adoption isn't the answer to improving the overall plight of children in developing countries. Even the strongest supporters admit the movement of adoptees across international borders represents only a tiny fraction of the neglected, abused and abandoned children in these countries. And supporters of international adoption are quiet about the children who are not adopted and left behind.”

The stripping of children from eastern Europe, Asia and South has been called colonialism and cultural genocide. According to Ethica, thirteen countries have suspended or ended their adoption programs in the past fifteen years. Another half dozen countries have temporarily stopped adoptions to investigate allegations of corruption or child trafficking, the latest Chad.

Jane Jeong Trenka (jjtrenka.worldpress.com)is a Korean born adoptee whose Korean mother searched and found her after she was sent to the U.S. and before she was legally adopted. Trenka was raised in rural Minnesota by white American parents, and has been going back and forth from Korea since 1995 maintaining continuous contact with her Korean family since 1988. She writes extensively about the need to end exporting children from Korea. Other Korean born adoptees are returning to their homeland, and some are filled with pain and anger that they were torn from their rich cultural heritage. (Vanessa Hua, “Korean-born in U.S. return to a home they never knew Many locate lost families, others work to change international adoption policy” San Francisco Chronicle. September 11, 2005)

Trenka says, “South Korea’s dependence on the international adoption program has stunted the growth of more appropriate government-funded social welfare programs, as well as delayed the social acceptance of single-parent families….International adoption is NOT the solution. Instead, the South Korean government must find its own solution by investing in sex education, supporting single parents and creating incentives for domestic adoption.” (Adoption from South Korea: Isn’t 50 Years Enough? Jane’s Blog, June 27th, 200)

Jae Ran Kim, a South Korea-born/American raised adoptee and social worker in the field of adoption and child welfare laments: “It is ethnocentric and arrogant to think that the United States has any business telling another country how they should manage the problem of orphaned, abandoned or relinquished children. We can’t even solve this problem within our own shores.(http://harlowmonkey.typepad.com/harlows_monkey/2006/08/adoptee_vs_adop.html)

Maureen Flatley political consultant and media advisor specializing in child welfare and adoption, observes: “Our national policy allows large sums of cash to leave the country in an entirely unregulated system and browbeating foreign governments into surrendering children in a decision-making process for their foster children that none of our fifty states would permit for America’s waiting children….Lacking training in foreign policy or a sound regulatory framework, would-be adoptive families and their adoption agencies are encouraged to navigate the increasingly complex and treacherous geopolitics of countries around the world with virtually no training and in many cases a vested self interest. The result has been diplomatic and emotional chaos.” (“Federal Regulation of International Adoption,” Decree, American Adoption Congress, 1999. www.childlaw.us/2005/05/federal_regulat.html)

Who is behind it all?

The Brits have also rightly pointed to U.S. restrictions on birth control and abortion as a contributing to “marketable” infants in the U.S. The religious right’s imposed morality is perfectly partnered with those whose livelihoods depend upon the redistribution of children.

In May, 2007 Evangelical Christians organizations such as Focus on the Family and pastors from across the nation held a three-day summit in Colorado. members of to promote adoption via a media blitz.

Focus on the Family founder James C. Dobson, a major player in this new path of evangelism, and present at the summit, expressed concern that foster parents typically are permitted to take children to church but cannot force religion on them. They must adhere to other state guidelines as well, some of which may contradict their faith such as parents “disciplining” their children physically with switches as taught by Dobson, a child psychologist.

While some of the flock may in fact adopt children from foster care, concern for orphaned and abandoned children is a smoke screen to use adoption as a tool against abortion, against single parenthood, and for evangelism. That is why, among those present at this event was Tom Atwood, president of the National Committee for Adoption, the largest lobbying organization of adoption agencies, primarily those of the Later Day Saints. The NCFA is also the major opposition to legislation aimed at restoring adoptees’ right to their own true identity.

The NCFA web page purports to be about finding homes for children in foster care, yet their mission page shows in black and white their first and foremost agenda item: “Train pregnancy counselors and health care workers in infant adoption awareness, so women and teens with unplanned pregnancies can freely consider the loving option of adoption.”

And, contrary to promoting the adoption of U.S. orphans, on the NCFA agenda is “Work[ing] with the U.S. and foreign governments to establish sound policies for inter-country adoption, so foreign orphans can be placed with loving, permanent families.”

The NCFA and the religious right are partners in a full-fledged propaganda war being waged to recruit Christian soldiers through adoption. With all the ingenuity and marketing skills available to them, the NCFA and the religious right couch their pro-adoption stance as a noble plan to help the hundred of thousands of children in foster care, using these kids as the foot in the door by both to get tax incentives and other benefits for their clients who seek to adopt primarily infants. All good social engineers know the advantages of starting with a “blank slate.” (For more on American adoption as social engineering see Barbara Melosh, Ellen Herman, and E. Wayne Carp.)

Ken Connor, the attorney who represented Governor Jeb Bush in the Terri Schiavo case and Vice Chairman of Americans United for Life, reporting on the pro-adoption summit (A Selfless Choice: In Celebration of Adoption, Townhall.com May 12, 2007) calls abortion big business and extols the “virtues” of adoption—a far bigger and corrupt—multi-billion dollar industry.

Connor goes on to tout infant adoption as a win-win for everyone including the mother who suffers a lose-lose: the irrevocable permanent loss of parental rights, her child, and her relationship with him.

Lost in the dogmatic rhetoric being spewed by both ideological extremes among pro-choice and pro-life proponents….is pro-family. UNICEF’s position is that adoption should be a last resort. “Families needing support to care for their children should receive it, and that alternative means of caring for a child should only be considered when, despite this assistance, a child’s family is unavailable, unable or unwilling to care for her or him.”

The only reason to encourage and promote more relinquishments and more adoptions is to fill a “demand” for healthy white infants, which, in fact, is counter to a goal of finding homes for older, non-white, or physically challenged children being supported by state funds. It is uncharitable and un-American. The same is true for supporting and encouraging international adoption.

Other items on their agenda list include the promotion of anti-family, anti-parenting programs such as so-called “safe havens” that allow for the legal abandonment of infants and putative father laws to speed relinquishments of newly born babies, causing one to ask if the real reason is to maintain the supply of “adoptable” [read acceptable] babies for their contributors, cronies, constituents or clients.

Pro-life organizations can be known by whatever family-orientated, all-American cutesie “baby saving” and “hope-filled” names…they may even invoke the name of, or believe that they are doing the work of, God…. but their tactics are all counter to true Family Preservation as spelled out in the constitution of the United States which protects parental rights; the United Nations Convention on the Rights of the Child; and message of Judeo-Christianity. Being pro-family means being supportive of all families…not judging who has the necessary finances or marital status.

Worldwide 80% of children in orphanages have families, most who visit them and hope to regain custody. Poverty is the major cause of children needing adoption, not abuse, neglect or abandonment. Removing children from impoverished families does nothing to ameliorate the plight of the family, village or nation from where they originate.

Not all international adoptions—nor all domestic infant adoptions—support corruption, but there is no way to distinguish which do or to determine the accurate source of children offered by international orphanages. We thus need to rethink our romanticized view of adoption as a “rescue” mission as well as ethnocentric international adoption policies that in many cases support black market trafficking operations. We need to rethink our child adoption policies that ignore the needs of hundreds of thousands of children in domestic foster care who cannot be reunited with family and might benefit from caring homes, and reduce tax loads, while we continue to import children for placement with families ill-equipped to handle their special needs.

Only when adoption puts the needs of orphans first before the demands of those seeking to be parents, can it be “celebrated”, encouraged and promoted.

Mirah Riben is the author of shedding light on…The Dark Side of Adoption (1988) and THE STORK MARKET: America’s Multi-Billion Dollar Unregulated Adoption Industry (2007) http://www.AdvocatePublications.com and on the Board of Directors of Origins-USA.org